| A | B |
|---|
| co-insurance | the percentage of the bill for services that the policy holder must pay |
| co-payment (co-pay) | a specific amount paid by the patient for each medical service / such as $15.00 for each doctor visit or each prescription filled |
| deductible | amount the patient must pay before the insurance starts to pay for services |
| group plan | the insured and, usually, their employer share the amount of the premium |
| Health Maintenance Organization (HMO) | insurance method that focuses on prevention of disease / must see providers from an approved list |
| Indemnity Plan | traditional health insurance plan with freedom to visit physician of choice |
| individual plan | the insured pays the total amount of the premium |
| Medicaid | government payment of healthcare services for people with low income / children who qualify for services and people who are disabled or blind |
| Medicare | government payment for healthcare for patients over 65, any person with a disability that has received social security benefits for at least 2 years, or anyone with end stage renal disease |
| Medigap | a private insurance policy that pays the difference between the medical charge and the amount that Medicare pays |
| Out-of-Pocket | medical bill that is not covered by insurance and must be paid by the patient |
| Preferred Provider Organization (PPO) | group of healthcare providers that provide services to a specific group / often at a reduced rate |
| premium | the periodic amount paid to an insurance company for healthcare or prescription drugs |
| private Insurance | the insured pays a monthly premium for insurance plan |
| reimbursement | amount paid to patient toward the cost of healthcare services |
| TRICARE | military health plan that provides services for active duty personnel and their families / survivors of military personnel and retired military personnel and their families |
| Veterans Health Administration | provides healthcare services to anyone who served in the military |
| Worker's Compensation | health insurance plan the pays for the healthcare of workers injured on the job |
| cost containment | methods used to control the cost of healthcare |
| diagnostic related groups (DRGs) | system to classify diagnoses into similar groups and is used to determine the amount of Medicare payment to a healthcare provider |
| for-profit agency | facility that operates for a monetary profit |
| Government agency | agency sponsored by the government and supported by taxes |
| Health Information Management Systems (HIMS) | management of personal healthcare information by the healthcare agency |
| In-patient Care | services provided to a patient within a hospital |
| managed care | healthcare system designed to reduce cost of healthcare |
| Outpatient Care | services that do not require the patient to stay overnight in the hospital |
| preventative care | the focus is to promote good health and to prevent illness |
| telemedicine | healthcare services provided from a distant place |
